The economic downturn has affected employment in many global markets and industries, but not the need for qualified nurses and health care workers in countries such as Japan.

However, the main barrier to allowing foreign nurses and care workers into the health care system in Japan is concern about how well prepared the foreign health workers will be to deal with Japanese language and culture.

The Japanese language alone is a formidable challenge for anyone coming to Japan, and if differences in medical standards, social rules and cultural habits such as food are added to the "must know" list for foreign health care workers to learn -- the employment chances get decidedly tougher.

However, Japan has inked agreements with members of ASEAN (Association of Southeast Asia Nations) to allow qualified health workers into the Japan to work as nurses and nurses assistants. At the moment the agreement is moving slowly while countries such as the Philippines and Indonesia work out the details with Tokyo about language and cultural training for health workers wanting to work in Japan.

Japan is badly in need of nurses, assistant nurses, and care workers to work in health facilities for its elderly population. Japan's population is rapidly ageing and there are not enough health workers from its own decreasing population base to provide care for the elderly.

In order to look at these challenges and find solutions, The Sasakawa Peace Foundation hosted a two-day conference at The Nippon Foundation in Tokyo entitled "Cross-Cultural Care in Globalization: Management of Nursing/Care work in Multi-Cultural Settings."

Experts from ASEAN and Japan were invited to the conference to compare experiences and discuss different viewpoints about how to best facilitate the integration of foreign health workers into their countries from the perspective of professional qualifications and cultural adaptation.

"It's already a given that countries such as Japan need foreign health care workers. The issue now is determining the best way to facilitate this," said Ada Cheng, Executive Officer of the Australian Nursing Home Foundation, and an expert on cross-cultural communication in the health services.

Cheng enumerated many areas that countries sending health careworkers and those receiving them need to seriously consider, including:
1) culturally appropriate care,
2) aspects of different cultures -- visible and invisible issues,
3) cultural awareness training -- for the sending country's workers and the receiving country's management and health staff,
4) risks of prejudice and stereotyping,
5) cultural safety in aged care,
6) the elements of cross cultural communication,
7) barriers to cross-cultural communication, and
8) being culturally competent through staff training and education for sending nation workers and receiving nation staff too.

In conclusion Cheng told the participants of the symposium, "an individual worker cannot be culturally competent alone. It requires organizational commitment. Management creates the service delivery structure and environment where cultural competence is possible."

The two-day conference was considered very timely in the context of ASEAN's demographic changes and international labor migration.